Passive screw locking mechanism

ABSTRACT

Methods and devices are provided for passively locking a bone screw within a bone plate. In particular, the methods and devices allow a bone screw to be locked within a thru-hole in a bone plate without requiring any additional locking steps. In an exemplary embodiment, an annular feature is provided in a thru-hole of a bone plate, or in a bushing that is disposed within a thru-hole of a bone plate, for engaging a bone screw. The annular feature can be configured such that it allows the bone screw to be inserted through the thru-hole at various insertion angles while still being effective to prevent back-out of the bone screw, thereby locking the screw to the plate.

FIELD OF THE INVENTION

The present invention relates to bone fixation methods and devices, andin particular to a passive locking mechanism for mating a bone screw toa bone plate.

BACKGROUND OF THE INVENTION

Bone fixation devices are useful for promoting the proper healing ofinjured or damaged vertebral bone segments caused by trauma, tumorgrowth, or degenerative disc disease. These external fixation devicesimmobilize the injured bone segments to ensure the proper growth of newosseous tissue between the damaged segments. External bone fixationdevices such as these often include internal bracing and instrumentationto stabilize the spinal column to facilitate the efficient healing ofthe damaged area without deformity or instability, while minimizing anyimmobilization and post-operative care of the patient.

One type of external bone fixation device is an osteosynthesis plate,more commonly referred to as a bone plate, that can be used toimmobilize adjacent skeletal parts such as vertebral bones. Typically,the fixation plate is a rigid metal or polymeric plate positioned tospan bones or bone segments that require immobilization with respect toone another. The plate is fastened to the respective bones, usinganchors such as bone screws, so that the plate remains in contact withthe bones and fixes them in a desired position. Anterior cervicalplates, for instance, can be useful in providing the mechanical supportnecessary to keep vertebral bodies in proper position and bridge aweakened or diseased area such as when a disc, vertebral body or spinalfragment has been removed. These anterior cervical plates usuallyinclude a rigid bone plate having a plurality of screw openings. Theopenings are either holes or slots that allow for freedom of screwmovement. The bone plate is placed against the damaged vertebral bodiesand bone screws are used to secure the bone plate to the spine, usuallywith the bone screws being driven into the vertebral bodies.

While current bone plates and bone screws are effective, unintentionalloosening of the screws can reduce the effectiveness of an anteriorconstruct and can result in erosion and irritation of the esophagus.Several techniques have been developed to prevent screw back-out,however many current techniques require the use of a second lockingmechanism that is applied to the bone screw or plate. This cancomplicate the procedure, as it requires the use of additional tools aswell as proper placement of the additional locking mechanism. Otherexisting techniques require precise alignment of the bone screw with thethru-hole in the bone plate, thereby limiting the insertion trajectoryof the bone screw.

Accordingly, there remains a need for improved methods and devices forlocking a bone screw to a bone plate.

SUMMARY OF THE INVENTION

Methods and devices are provided for passively locking a bone screw to abone plate. In one embodiment, a locking plate apparatus is provided andincludes a body having a thru-hole formed therein and an annular featureformed on an internal surface of the thru-hole. The apparatus can alsoinclude a bone screw having a threaded shaft adapted to engage theannular feature upon insertion of the threaded shaft through thethru-hole.

The body can have a variety of configurations, for example the body canbe a bone plate having the thru-hole formed therein. In anotherembodiment, the body can be a bushing having the thru-hole formedtherein. The bushing can be adapted to be seated within a thru-hole in abone plate. In certain exemplary embodiments, the bushing is split,e.g., c-shaped. The bushing can also include a radial exterior surfacesized to permit polyaxial rotation of the bushing within a thru-hole ina bone plate.

The bone screw can also have a variety of configurations, but in anexemplary embodiment the bone screw includes a head that is formed on aproximal end of a threaded shaft and that is adapted to be at leastpartially seated within the thru-hole in the body. The threaded shaftcan have an outer or major diameter that is greater than an innerdiameter of the annular feature, and an inner or minor diameter that isless than an inner diameter of the annular feature, such that theannular feature engages the threads when the bone screw is insertedthrough the thru-hole. The bone screw can also include an annular grooveformed on or adjacent to the head and/or the threaded shaft for seatingthe annular feature. The bone screw can also have other features. Forexample, the head of the bone screw can be tapered for seating within acorresponding tapered portion of the thru-hole.

The annular feature can also have a variety of configurations. Theannular feature can be, for example, an annular flange disposed aroundan inner surface of the thru-hole, or a plurality of flanges or tabsspaced annularly around an inner surface of the thru-hole. In anexemplary embodiment, the annular feature resides within a single plane,which can optionally be perpendicular to a longitudinal axis of thethru-hole. In use, the annular feature can be sized to engage threads onthe bone screw and to retain the bone screw within the body.

In another embodiment, a method for locking a bone screw within a plateis provided and includes positioning a body having a thru-hole on a bonesurface. The thru-hole can include an annular feature formed therein.The method can also include inserting a bone screw through the thru-holein the body and into bone. Threads on the bone screw can engage theannular feature as the bone screw is inserted through the thru-hole. Inan exemplary embodiment, the annular feature resides in a single planesuch that the bone screw can be inserted through the thru-hole atvarious insertion angles relative to an axis of the thru-hole. Onceimplanted, the annular feature will retain the bone screw within thethru-hole thereby preventing back-out.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1A is a perspective view of one embodiment of a bushing having anannular feature formed therein;

FIG. 1B is a top view of the bushing of FIG. 1A;

FIG. 1C is a side cross-sectional view of the bushing of FIG. 1A;

FIG. 2A is a top view of another embodiment of a bushing having anannular feature formed therein;

FIG. 2B is a perspective view of the bushing of FIG. 2A;

FIG. 3A is a side view of one embodiment of a bone screw;

FIG. 3B is a side view of another embodiment of a bone screw;

FIG. 4 is a top view of one embodiment of a bone plate;

FIG. 5 is a side cross-sectional view of the bone screw of FIG. 3Adisposed within the bushing of FIG. 1A, which is seated in a thru-holeof the bone plate of FIG. 4;

FIG. 6 is an illustration showing the bone screw, bushing, and boneplate of FIG. 5 in use in bone.

DETAILED DESCRIPTION OF THE INVENTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

The present invention generally provides methods and devices forpassively locking a bone screw within a bone plate. In particular, themethods and devices allow a bone screw to be locked within a thru-holein a bone plate without requiring any additional locking steps. In anexemplary embodiment, an annular feature is provided in a thru-hole of abody, such as a bone plate or a bushing that is disposed within athru-hole of a bone plate, for engaging a bone screw. The annularfeature can be configured such that it allows the bone screw to beinserted through the thru-hole at various insertion angles while stillbeing effective to prevent back-out of the bone screw, thereby lockingthe screw to the plate. A person skilled in the art will appreciatethat, while the invention is described as not requiring any additionallocking steps, various locking mechanisms known in the art can be usedin combination with the passive locking feature disclosed herein.

As indicated above, in one embodiment an annular feature is provided ina thru-hole of a bone plate, or in a bushing that is disposed within athru-hole of a bone plate, for engaging a bone screw. FIGS. 1A-1Cillustrate one exemplary embodiment of an annular feature 20 that isformed around an inner surface 18 of a thru-bore 11 in a bushing 10. Theparticular configuration of the bushing 10 can vary, but the illustratedbushing 10 is a split bushing that is generally C-shaped. Other slot orcut-out configurations can be used to allow radial expansion of thebushing, or alternatively the bushing can be ring-shaped. Theillustrated bushing 10 generally includes a first or proximal end 12that is configured to lie adjacent to a proximal surface of a boneplate, and a second or distal end 14 that is configured to lie adjacentto a distal, bone-contacting surface of a bone plate, as will bediscussed in more detail below. An outer surface 16 of the bushing 10can be sized and shaped to match the inner surface of the thru-hole in abone plate. As shown in FIG. 1A, the outer surface of the bushing has agenerally convex spherical shape extending between the first and secondends 12, 14 such that the bushing 10 can be seated within a thru-holehaving a generally concave spherical inner surface extending betweenfirst and second surfaces of the bone plate. This will allow the bushing10 to move polyaxially relative to the plate. The outer surface 16 ofthe bushing 10 can also include surface features formed thereon tofacilitate frictional engagement with the thru-hole in a bone plate.FIGS. 1A and 1C illustrate ridges 17 extending radially around thebushing 10. A variety of other surface features or textures can be usedto facilitate engagement between the bushing 10 and a thru-hole, oralternatively the bushing 10 can have a smooth outer surface. The innersurface 18 of the bushing 10 can also have a variety of configurations,but in an exemplary embodiment the inner surface 18 has a diameter dthat decreases from the proximal end 12 to the distal end 14 such thatthe thru-bore 11 is tapered.

Continuing to refer to FIGS. 1A-1C, the annular feature 20 can have avariety of configurations but in the illustrated embodiment the annularfeature 20 is in the form of an annular flange or protrusion thatextends radially around the inner surface 18 of the bushing 10. Thediameter D₁ of the annular feature 20 can vary, but it is preferablysized to engage the threads of the bone screw to prevent screw back-outonce the bone screw is implanted. In an exemplary embodiment, theannular feature 20 has a diameter D₁ that is greater than a major orouter diameter of the threads of a bone screw inserted therethrough, andthat is less than a minor or inner diameter of the threads of a bonescrew inserted therethrough (i.e., the diameter of the shank). The innerdiameter D₁ of the annular feature 20 is also preferably smaller thanthe smallest outer diameter of a head of the bone screw so as to preventthe head of the bone screw from passing therethrough. Exemplary bonescrews will be discussed in more detail below with respect to FIGS. 3Aand 3B.

The particular location of the annular feature 20 within the thru-hole11 of the bushing 10 can also vary. In the illustrated embodiment theannular feature 20 is positioned adjacent to a distal end of thethru-hole 11, i.e., adjacent to the distal-most end 14 of the bushing10. This configuration will allow the annular feature to engage the bonescrew at a location between the shank and the head, as will be discussedin more detail below. A person skilled in the art will appreciate thatthe annular feature can be located at any portion in the bushing, andthat the particular location can vary depending on the configuration ofthe bone screw. Moreover, while a bushing is shown, the annular featurecan be formed in a thru-hole in a bone plate such that the bone platehas a thru-hole with the same configuration as thru-hole 11.

As further shown in FIGS. 1A-1C, the annular feature 20 can also residein a single plane P such that the annular feature 20 is non-helical ornon-threaded. The angle of the plane P relative to a central axis A ofthe thru-hole 11 can vary. For example, the annular feature 20 canreside in a plane P that extends at an angle α that is greater than orless than 90° relative to the central axis A of the thru-hole 11. In theillustrated embodiment, the annular feature 20 resides in a plane P thatis perpendicular to the central axis A of the thru-hole 11 such that theplane P extends at an angle α of 90° relative to the central axis A. Inuse, the planar configuration of the annular feature 20 will allow abone screw to be inserted at various trajectories or insertion anglesrelative to the thru-hole 11, as the annular feature 20 will extendbetween the threads without requiring the tight constraints and properalignment that are necessary with a thread-on-thread connection. Aperson skilled in the art will appreciate that the thru-hole 11 can,however, include a partial thread formed therein, in addition to theannular feature, for positioning the bone screw at a predeterminedtrajectory relative to the thru-hole. Moreover, while only one annularfeature is shown, the thru-hole 11 can include multiple annular featuresresiding in separate planes.

FIGS. 2A-2B illustrate yet another embodiment of an annular feature 20′that is configured to lock a bone screw within a thru-hole in a plate.As with the embodiment shown in FIGS. 1A-1C, the annular feature 20′ isformed within a thru-hole 11′ of a bushing 10′ and resides in a singleplane. The annular feature 20′ also similarly has an inner diameter D₁′that is greater than a major diameter of the threads on a bone screw,but less than a minor diameter of the threads on the bone screw, as willbe discussed in more detail below. In this embodiment, however, ratherthan extending around an entire inner surface 18′ of the bushing 10′,the annular feature 20′ is in the form of multiple protrusions orflanges that are positioned annularly around an inner surface 18′ of thebushing 10′. FIGS. 2A-2B illustrate three protrusions spaced radiallyaround the inner surface 18′ of the bushing 10′.

As indicated above, the annular feature can be configured to engage abone screw to lock the bone screw to a bone plate. FIG. 3A illustratesone exemplary embodiment of a bone screw 30 for use with the bushings10, 10′ shown in FIGS. 1A-2B. In general, the bone screw 30 includes ahead 32 and a shank 34 extending distally therefrom. The head 32 can besized to be at least partially received within a thru-hole 11, 11′ inthe bushing 10, 10′, or within a thru-hole in a bone plate. In anexemplary embodiment, the head 32 has a diameter d_(h) that is greaterthan the inner diameter D₁, D₁′ of the annular feature 20, 20′ such thatthe annular feature 20, 20′ prevents passage of the head 32 through thethru-hole 11, 11′. The shank 34 includes threads 36 formed thereon andextending between proximal and distal ends 34 a, 34 b of the shank 34.The shape of the tip of bone screw 30 can vary, and the tip can beself-drilling or self-tapping if desired. In order to allow the annularfeature 20, 20′ to lock the bone screw 30 to a bone plate, the threads36 on the shank 34 can have a major diameter D₂ that is greater than theinner diameter D₁, D₁′ of the annular feature 20, 20′, and a minordiameter D₃, i.e., the diameter of the shank, that is less than theinner diameter D₁, D₁′ of the annular feature 20, 20′. This will allowthe annular feature 20, 20′ to extend between the threads 36 as the bonescrew 30 is threaded therethrough. As previously indicated, since theannular feature 20, 20′ resides in a single plane, the bone screw 30 canbe inserted at various trajectories or insertion angles relative to theannular feature 20, 20′, thus allowing easy insertion of the bone screw30 into bone.

As further shown in FIG. 3A, the bone screw 30 can include an annulargroove 38 formed on or adjacent to the head 32 and/or the proximal end34 a of the shank 34. In the illustrated embodiment, the groove 38 islocated between the proximal end of the shank 34 and the head 32. Aperson skilled in the art will appreciate that in describing the grooveas being formed “between” the head 32 and the shank 34, the groove cannecessarily be formed on only one of the head 32 and the shank 34, or ona portion of both the head 32 and the shank 34. The threads 36 on theshank 34 can also continue into the groove 38 and terminate at the head32, as shown in FIG. 3A, or they can terminate prior to the groove. FIG.3B illustrates a bone screw 30′ having threads 36′ that terminate priorto a groove 38′ 3B. In use, the annular groove 38 is configured to seatthe annular feature 20, 20′ on the bushing (or on a bone plate) once thebone screw 30 is threaded therethrough, as will be discussed in moredetail below. In an exemplary embodiment, the annular groove 30 has aheight h that is greater than a height of the annular feature 20, 20′.This will allow the bone screw 30 to be fully threaded into bone withoutinterference from the annular feature 20, 20′. A person skilled in theart will appreciate that the bone screw can have a variety ofconfigurations, and that various bone screws known in the art can beused.

FIG. 4 illustrates one exemplary embodiment of a bone plate 40 that canbe used with the bushings 10, 10′ of FIGS. 1A-2B and with the bonescrews 30, 30′ of FIGS. 3A and 3B. As shown, the bone plate 40 has agenerally planar configuration with a first, superior surface 42 and asecond, inferior bone-contacting surface 44. The plate 40 can includeany number of thru-holes formed therein and extending between thesuperior and inferior surfaces 42, 44. In the illustrated embodiment,the plate 40 includes four thru-holes 46 formed therein for receivingfour bone screws. The plate 40 can also include additional features tofacilitate use of the implant. In this embodiment, each thru-hole 46 issized and shaped to seat a bushing therein such that, when a bone screwis inserted through the bushing and into bone, an interference fit iscreated between the head of the bone screw, the bushing, and thethru-hole 46 in the plate 40.

In use, the annular feature will lock the bone screw to the plate. Inparticular, a bushing can be disposed within a thru-hole in a plate (oralternatively the annular feature can be formed directly in thethru-hole in the plate). The plate can be positioned against a bonesurface, such as against a vertebra in a spinal column. Once the bone isprepared, e.g., by drilling, tapping, etc., a bone screw can be passedthrough the thru-hole in the bushing (or the thru-hole in the platewhere the annular feature is formed in the plate) and threaded intobone. FIGS. 5 and 6 illustrate the bone screw 30 of FIG. 3A disposedthrough the bushing 10 of FIGS. 1A-1C, which is seated within athru-hole 26 in the plate 40 of FIG. 4. As shown, the annular feature 20is disposed within the annular groove 38 formed around the bone screw 30such that the annular feature 20 will abut the proximal-most surface 36p of the thread 36 on the bone screw 30 to prevent the screw 30 frombacking out of the plate 40. Thus, in order to remove the bone screw 30from the bone plate 40, the screw 30 will need to be unthreaded. Theannular feature 20 is therefore effective to passively lock the bonescrew 30 to the plate 40, as additional locking mechanisms are notrequired.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. A method for locking a bone screw within a plate,comprising: positioning a plate having a thru-hole on a bone surface,the thru-hole including a bushing disposed therein and having an annularfeature formed on an internal surface thereof; and inserting a bonescrew through the bushing and into bone, threads on the bone screwengaging the annular feature as the bone screw is inserted through thebushing, and the annular feature abutting a proximal-most surface of thethreads on the threaded shaft when the threaded shaft is threadedthrough the thru-hole; wherein the annular feature resides in a singleplane such that the bone screw can be inserted through the hushing atvarious insertion angles relative to an axis of the thru-hole.
 2. Themethod of claim 1, wherein the annular feature engages an annular grooveformed between a head and the threads of the bone screw.
 3. The methodof claim 1, wherein the bushing is a split hushing.
 4. The method ofclaim 1, wherein the bushing is polyaxially rotatable within thethru-hole in the plate.
 5. The method of claim 1, wherein the bone screwincludes a head that is received within the bushing.
 6. The method ofclaim 1, wherein the annular feature engages an annular groove formedbetween the threads and the head of the hone screw when the head isseated within the bushing.
 7. The method of claim 1, wherein the threadshave a major diameter that is greater than an inner diameter of theannular feature, and the threaded shank has a minor diameter that isless than an inner diameter of the annular feature.
 8. The method ofclaim 1, wherein the annular feature comprises an annular flangedisposed around the internal surface of the bushing.
 9. The method ofclaim 1, wherein the annular feature comprises a plurality of tabsspaced annularly around the internal surface of the bushing.